Green Acres Rescue Adoption Form

Green Acres Rescue Adoption Form

To be considered for an adoptable dog, you must be at least 21 years of age, have identification showing your present address and have the knowledge and consent of your landlord, which will be verified.
Adoption Process

Once your application has been reviewed, we will contact you for additional questions and/or to schedule a meet and greet* with the dog you are interested in.

*We want you to meet your prospective family member. If you decide he/she is not the right fit for you or you family, then no further paperwork is necessary.

At the meet and greet, we will ask for your identification to confirm your age and current address.

After a meet and greet:

We’ll confirm your landlord allows the dog (if you rent your home).

We’ll contact your current or past veterinarian(s) as provided in the application.

We’ll reach out to your personal references.

We’ll do a home visit.

Adoption Fee

The adoption fee is $150. The fee covers vaccinations, county license, microchip and spay/neuter.
What dog are you interested in adopting?
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Type of Residence*
If Other Residence, what kind
Own/Rent*

OwnRent
If renting provide landlord name and phone number

First NameLast Name
Landlord Phone Number
Is your yard Fenced in*

YesNo
Do you plan on the dog being inside or outside*

InsideOutside
When you are gone for work, errands, etc, where will the dog be kept?*
Including yourself, how many people will live in the home with this pet? How many are adults? How many are children?*
List all animals in the home - type, age, gender, number of each and description of personality or behavioral issues.*
If you currently have pets, are they all spayed/neutered? Current on shots? Are your dog(s) on flea and/or heartworm prevention? If not, please explain why not. *
What are you looking for in a dog: companionship, security and/or other active companionship (e.g., hiking, running):*
If you do not have pets currently, what is your experience or history with pet ownership? Have you had to give up a pet in the past?*
Veterinarian Reference(s)

NamePhone Number
NamePhone Number
Please provide two personal references, excluding family members.
Reference #1*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Reference #2*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Should be Empty: